This 95 year old woman had a defect of her nasal sidewall, tip, and ala after removal of a basal cell cancer with Mohs surgery. Dr. Amit Bhrany reconstructed her nose with cartilage grafts to support the structure of the nasal ala to prevent nostril notching (alar retraction), a skin graft, and an interpolated local flap from her cheek (melolabial flap) for the skin. She is shown 7 months post-operative.